摘要
目的探讨坏疽性胆囊炎的危险因素,提高术前诊断坏疽性胆囊炎的准确性。方法回顾性分析39例坏疽性胆囊炎与441例非坏疽胆囊炎患者术前临床资料,采用Logistic回归分析法分析性别、年龄、肥胖、糖尿病、体温、右上腹肌紧张状态、腹部B超表现、白细胞计数等指标与坏疽性胆囊炎之间的关系。结果经单因素Logistic回归分析发现,患者年龄≥60岁,肥胖,糖尿病,体温≥38℃,右上腹肌紧张,B超显示胆囊颈部结石嵌顿,胆囊壁厚≥4 mm,胆囊周围积液及胆囊壁线性中断为坏疽性胆囊炎的危险因素。多因素Logistic回归分析发现,最终胆囊颈部结石嵌顿(OR=7.182,P=0.001)、胆囊壁厚≥4 mm(OR=12.493,P<0.001)、体温≥38℃(OR=13.216,P<0.001)及胆囊壁线性中断(OR=15.337,P<0.001)4个因素进入回归方程。结论胆囊颈部结石嵌顿、胆囊壁厚≥4 mm、体温≥38℃及胆囊壁线性中断为坏疽性胆囊炎的独立危险因素,其影响强度依次增强。
objective To investigate the risk factors for gangrenous cholecystitis（GC）, and to improve the preoperative diagnosis accuracy of GC. Methods The preoperative clinical data of 39 patients with GC and 441 patients with non GC were analyzed retrospectively. Logistic regression analysis was used to investigate the relationship among gender, age, obesity, diabetes, body temperature, right upper quadrant muscular rigidity, abdominal ultrasound findings, white blood cell count and other clinical data with GC. Results In single factor Logistic regression analysis, age≥60 years, obesity, diabetes, body temperature≥38 ℃, right upper quadrant muscular rigidity, gallbladder neck calculus impaction, gallbladder wall thickness≥4 mm, pericholecystic fluid, and irregular outline of gallbladder wall were risk factors for GC, further multiple regression analysis showed that gallbladder neck calculus impaction（OR=7.182, P=0.001）, gallbladder wall thickness≥4 mm（OR=12.493, P〈0.001）, body temperature≥38 ℃（OR=13.216, P〈0.001） and irregular outline of gallbladder wall（OR=15.337, P〈0.001） entered the regression equation. Conclusion Gallbladder neck calculus impaction, gallbladder wall thickness≥4 mm, body temperature≥38 ℃ and irregular outline of gallbladder wall are independent risk factors for GC, and the effect intension of them to GC gradually increase.
出处
《肝胆胰外科杂志》
CAS
2016年第4期278-281,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
坏疽性胆囊炎
危险因素
回归分析
gangrenous cholecystitis
risk factors
regression analysis
